Prospective Analytics: AI-powered condition suspects & recaptures
Risk adjustment teams face internal financial pressure and growing regulatory pressure to move away from retrospective chart reviews for Medicare Advantage. To maximize patient engagement, reduce provider abrasion from retrospective reviews, and facilitate more accurate risk capture upstream, many organizations are implementing prospective programs that equip physician offices with information to improve condition coding, support care gap closures, and develop a more holistic view of patient heath. But developing an accurate, actionable list of condition opportunities is time-consuming and complicated.
Apixio’s Prospective Analytics solution uses AI algorithms to generate a list of suspected & known risk-adjusting patient conditions, powering your prospective program with reliable, targeted intelligence.